UNASSIGNED: Teachers in medicine do not only teach scientific facts about health and disease to their learners but they are also looked up to as role models. Little is known about the qualities of consultant-faculty members who are regarded as role models by Filipino internal medicine residents.
UNASSIGNED: This study aimed to determine the reasons why consultant-faculty members are considered role models by Filipino internal medicine residents.
UNASSIGNED: A cross-sectional survey was conducted among internal medicine residents at a tertiary national university hospital in the Philippines. Participants were asked to give the reasons for citing consultant-faculty members who they consider as role models.
UNASSIGNED: There were 81 residents who participated (93% response rate) who gave a total of 332 qualities as reasons for citing them as role models. The most commonly cited quality category was those of personal qualities (35.84% of all responses). This was followed by academic, clinical, teaching, leadership and research qualities. Physical qualities were the least cited (0.30% of all responses). Across the four batches of residents, personal qualities were consistently cited the most number of times, while physical qualities were consistently cited the least.
UNASSIGNED: Filipino internal medicine residents identified personal qualities as the most frequent reason for considering their consultant-faculty as role models.

Women represented 29% of cardiology trainees and 16% of consultants in the UK in 2021. While the numbers of women in cardiology have increased over the last 20 years, these proportions remain among the lowest in comparison with other medical specialties. This essay aims to explore the contributing factors behind, and plans to reduce, gender disparity in cardiology. PubMed was searched using keywords such as \'gender\', \'inequality\', \'women\', \'training\' and \'cardiology\'. Retrieved studies were screened for themes contributing towards, and strategies to overcome, gender inequality within cardiology. Reasons for gender inequality included poor perceptions of cardiology as a female-friendly specialty, experiences of gender-based discrimination, inflexible working hours, poor work- life balance, and lack of female role models. Recommended resolutions should target these themes; increase opportunities for flexible working hours, enforce a discrimination-free workplace culture, and encourage mentoring relationships between female senior and junior doctors. Improving the experience of the existing female workforce in cardiology will have a knock-on effect on the perceptions of trainees rotating through departments, in addition to initiatives promoting cardiology as a female-friendly specialty. In conclusion, promoting gender equality within cardiology remains an ongoing challenge. Nationwide efforts to increase retention and improve perceptions should target issues highlighted by the voices of women.

OBJECTIVE: Central venous catheterization (CVC) carries inherent risks which can be mitigated through the use of appropriate ultrasound-guidance during needle insertion. This study aims to comprehensively understand patient anatomy as it is visualized during CVC by employing a semi-automated image analysis method to track the internal jugular vein and carotid artery throughout recorded ultrasound videos.
METHODS: The ultrasound visualization of 50 CVC procedures were recorded at Penn State Health Milton S. Hershey Medical Center. The developed algorithm was used to detect the vessel edges, calculating metrics such as area, position, and eccentricity.
RESULTS: Results show typical anatomical variations of the vein and artery, with the artery being more circular and posterior to the vein in most cases. Notably, two cases revealed atypical artery positions, emphasizing the algorithm\'s precision in detecting anomalies. Additionally, dynamic vessel properties were analyzed, with the vein compressing on average to 13.4% of its original size and the artery expanding by 13.2%.
CONCLUSIONS: This study provides valuable insights which can be used to increase the accuracy of training simulations, thus enhancing medical education and procedural expertise. Furthermore, the novel approach of employing automated data analysis techniques to clinical recordings showcases the potential for continual assessment of patient anatomy, which could be useful in future advancements.

As Designated Institutional Officer (LMB) and Program Director (EM) in a community teaching hospital, we are intimately involved with all aspects of Graduate Medical Education (GME) and find the rewarding part to consist of contributing towards the teaching of our future physicians, as well as the challenges imposed by the continuously evolving training requirements as set forth by the Accreditation Council for Graduate Medical Education (ACGME). While we are very aware of the standard training requisites that are put in place without exception for all accredited GME residency programs, whether they are part of a major (University) or minor (Community) teaching medical center, in this manuscript we are hoping to perhaps initiate a dialogue among clinical educators as to the future of graduate medical training, and how we as a medical community can commit to providing the best education experience for our residents, while preparing them to be the physicians our patients expect and deserve.

Healthcare discriminations based on one\'s ethnic background is increasingly being studied in medicine. The scale of the Covid-19 pandemic has played an important role in bringing them to light. Data, although scarce, exist in France. These discriminations have an impact on the care pathway and contribute to the renunciation of care by the most affected populations. The issue of discrimination is particularly relevant in infectious diseases. Although the epidemiology of infectious diseases is unevenly distributed worldwide, erroneous social representations are prevalent and expose to a harmful prejudice against migrants with regard to infectious diseases. The transmissible nature of some infectious diseases reinforces their stigmatizing potential. In this context, it seems important to discuss the dimension to be given to social determinants, geographical origin, phenotype, and ethnicity in teaching and medical reasoning. The English-speaking world uses the concept of \"race\" in a structural way, whereas this \"international standard\" has not been applied in France until now. To improve the care of people from minority groups, it seems important to better document and teach a more nuanced clinical reasoning based on origin, without neglecting the importance of collecting and taking into account social determinants of health and environmental factors.

OBJECTIVE: Three-dimensional (3D) endoscopy has been developed to provide depth perception to allow for improved visualisation during otolaryngology surgery. We conducted a systematic review to determine the surgical safety and efficacy of 3D endoscopy in comparison to two-dimensional (2D) endoscopy in performing otolaryngology procedures, and the role of 3D endoscopy as a training tool for novice otolaryngology surgeons.
METHODS: Primary studies were identified through MEDLINE, Embase and Web of Science databases, which were searched for articles published through June 2022 that compared the outcomes of 2D and 3D endoscopy in otolaryngology surgical procedures or otolaryngology-relevant simulations. Candidate articles were independently reviewed by two authors.
RESULTS: A total of 18 full-text articles met inclusion criteria for this study. In clinical trials (n = 8 studies, 362 subjects), there were no significant differences in performance time, intraoperative or postoperative complications with 3D endoscopes when compared to 2D. In simulation studies (n = 10 studies, 336 participants), 3D endoscopes demonstrated a decreased error rate (n = 5 studies) and shorter performance time (n = 3 studies). Studies also reported improved depth perception (n = 14 studies) and visualisation preference (n = 5 studies) with 3D over 2D systems. The 3D systems were found to have a shorter learning curve and better manoeuvrability among novice surgeons.
CONCLUSIONS: 3D endoscopy showed equivalent safety and efficacy compared to 2D endoscopy in otolaryngology surgery. The improved depth perception and performance for novices using 3D endoscopes suggests the technology may be superior to 2D endoscopes as a training tool for otolaryngology surgeons.

BACKGROUND: Artificial intelligence (AI), more specifically large language models (LLMs), holds significant potential in revolutionizing emergency care delivery by optimizing clinical workflows and enhancing the quality of decision-making. Although enthusiasm for integrating LLMs into emergency medicine (EM) is growing, the existing literature is characterized by a disparate collection of individual studies, conceptual analyses, and preliminary implementations. Given these complexities and gaps in understanding, a cohesive framework is needed to comprehend the existing body of knowledge on the application of LLMs in EM.
OBJECTIVE: Given the absence of a comprehensive framework for exploring the roles of LLMs in EM, this scoping review aims to systematically map the existing literature on LLMs\' potential applications within EM and identify directions for future research. Addressing this gap will allow for informed advancements in the field.
METHODS: Using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) criteria, we searched Ovid MEDLINE, Embase, Web of Science, and Google Scholar for papers published between January 2018 and August 2023 that discussed LLMs\' use in EM. We excluded other forms of AI. A total of 1994 unique titles and abstracts were screened, and each full-text paper was independently reviewed by 2 authors. Data were abstracted independently, and 5 authors performed a collaborative quantitative and qualitative synthesis of the data.
RESULTS: A total of 43 papers were included. Studies were predominantly from 2022 to 2023 and conducted in the United States and China. We uncovered four major themes: (1) clinical decision-making and support was highlighted as a pivotal area, with LLMs playing a substantial role in enhancing patient care, notably through their application in real-time triage, allowing early recognition of patient urgency; (2) efficiency, workflow, and information management demonstrated the capacity of LLMs to significantly boost operational efficiency, particularly through the automation of patient record synthesis, which could reduce administrative burden and enhance patient-centric care; (3) risks, ethics, and transparency were identified as areas of concern, especially regarding the reliability of LLMs\' outputs, and specific studies highlighted the challenges of ensuring unbiased decision-making amidst potentially flawed training data sets, stressing the importance of thorough validation and ethical oversight; and (4) education and communication possibilities included LLMs\' capacity to enrich medical training, such as through using simulated patient interactions that enhance communication skills.
CONCLUSIONS: LLMs have the potential to fundamentally transform EM, enhancing clinical decision-making, optimizing workflows, and improving patient outcomes. This review sets the stage for future advancements by identifying key research areas: prospective validation of LLM applications, establishing standards for responsible use, understanding provider and patient perceptions, and improving physicians\' AI literacy. Effective integration of LLMs into EM will require collaborative efforts and thorough evaluation to ensure these technologies can be safely and effectively applied.

BACKGROUND: Medical careers increase infertility risks and pregnancy complications. Residents often postpone pregnancy, contributing to these risks. Limited data exist regarding residents\' family planning concerns. This study aims to evaluate fertility concerns and family planning during residency via a survey of residents and attending physicians.
METHODS: Anonymous online surveys were distributed to all residents (n = 1030) and attending physicians (n = 1111) at a large, urban, single-campus academic hospital center. Data analysis was performed using chi-square analysis with significance at P < 0.05.
RESULTS: Two hundred nine residents and 111 attendings submitted responses. Most respondents were female (74.7%). Slightly more than one-quarter of respondents were from a surgical specialty (26.6%). Residents compared to attending physicians indicated a higher concern for infertility during (57.4% versus 38.3%, P = 0.006) and after residency (68.9% versus 51.9%, P = 0.011) and a greater concern about pregnancy complications (67.8% versus 38.0%, P < 0.001). Most respondents felt pregnancy could negatively affect their training (67.3%). Surgical respondents were more concerned about the negative effects on colleagues (68.8% versus 51.1%, P = 0.045). Residents considered oocyte preservation more (57.9% versus 20.3%, P < 0.001). Respondents in surgical specialties had more concerns for fertility after residency (72.6% versus 57.9%, P = 0.033). Those in surgical fields trended for consideration of oocyte preservation (53.4% versus 39.7%, P = 0.084). Most respondents reported a need for education on oocyte preservation during residency (94.5%).
CONCLUSIONS: Residents have increasing concerns about fertility and family planning related to their training. In addition to more institutional and residency program support, residents desire dedicated fertility and family planning education, such as oocyte preservation, as part of their curriculum.

Background The use of telemedicine in contemporary healthcare has become essential, providing a novel method of delivering care, particularly in rural and underdeveloped areas. This study assesses the telemedicine awareness, knowledge, attitude, skills, and challenges among physicians working in tertiary care hospitals. Methods A cross-sectional study was carried out with 100 doctors from diverse specialties at a tertiary care institution. The questionnaire evaluated five domains: telemedicine awareness and knowledge, telemedicine attitude, telemedicine technology skills, telemedicine utilization patterns, and perceived barriers and educational needs. Results The study indicated that 95% of participants were aware of telemedicine. However, knowledge gaps remained, particularly in legal and ethical concerns (50%) and international rules (40%). Eighty percent of respondents had a favorable opinion of telemedicine, and 85% thought it might improve patient care in rural regions. The proficiency level of telemedicine users was variable: 60% of them had previous experience, and 70% of them rated their proficiency as intermediate or better. According to utilization patterns, 50% of telemedicine users used it at least once a week, primarily for remote monitoring (30%) and video consultations (60%). The study found that 90% of respondents had a high demand for training and educational opportunities. The absence of infrastructure (65%), worries about data security (55%), and patient acceptability (30%) were the main obstacles found. It also highlighted how important it is to have defined policies and collaborate across disciplines. Conclusion The study identifies a good attitude toward telemedicine among doctors as well as a need for improved training and infrastructure. It is essential to tackle these requirements and obstacles in order to successfully incorporate telemedicine into healthcare systems.

Longitudinal integrated clerkships (LICs) are effective in promoting careers in rural primary health care environments. This model of training medical professionals involves longer clinical placements of medical students and a different approach to learning which better prepares them for primary health care practice. Stellenbosch University created a LIC in 2011 for this purpose and has trained almost 100 doctors in their yearlong LIC since then. The past 12 years have brought about a lot of learning as this model of training was implemented, developed, and refined to suit the needs of students and the clinical environments.Contribution: Countries across the globe face challenges in recruiting and retaining doctors in rural primary health care environments. Longitudinal integrated clerkships have several educational benefits in addition to increase recruitment and retention of rural doctors, and 12 years of experience have led to a greater understanding regarding implementation and outcomes of an LIC in the South African context.